Ethnic and gender bias in objective structured clinical examination: A critical review

2021 ◽  
Vol 4 (2) ◽  
pp. 37
Author(s):  
IrisC. I. Chao ◽  
Efrem Violato ◽  
Brendan Concannon ◽  
Charlotte McCartan ◽  
Sharla King ◽  
...  
2019 ◽  
Author(s):  
Iris C.I. Chao ◽  
Efrem Violato ◽  
Brendan Concannon ◽  
Charlotte McCartan ◽  
Katarzyna Nicpon ◽  
...  

Abstract Background: Several forms of bias, including ethnic and gender bias, are thought to impact evaluations on Clinical Performance Assessments (CPAs). Unfairness may influence student learning attitudes if a loss of trust causes a lack of engagement in learning. Understanding the biases occurring in CPAs can lead to well-designed examiner training to ensure equality and fairness. The purpose of this systematic review is to determine the current evidence in the literature for ethnic and/or gender bias by examiners evaluating pre-licensure healthcare students in CPAs using standardized patients (SPs). Methods: Literature was systematically searched in CINAHL, PubMed and Medline from inception to February 2019, and no date range was set. Studies related to the investigation of ethnic and/or gender biases occurring in CPAs using SPs for examining health professions students were selected. A systematic review was conducted to assess the methodological quality and strength of evidence of relevant research and to identify if any potential ethnic and/or gender bias occurred in CPAs. The Guidelines for Critical Review were used to appraise the selected studies. Results: Nine studies published from 2003 to 2017 were retrieved for review. Three studies met all the Guidelines for Critical Review quality criteria, indicating stronger evidence of their outcomes, two of the studies reported ethnic and/or gender bias existing in the CPAs. Overall, four studies found ethnic and/or gender bias in CPAs, but all study results had small effect sizes. Conclusions: No systematic and consistent bias was found across the studies; nonetheless, the possibility of ethnic or gender bias by some examiners cannot be ignored. To minimize potential examiner bias, the investigation of Frame of Reference training, multiple examiners per station, and combination assessments in CPAs is recommended.


2020 ◽  
Author(s):  
Joana Le Boudec ◽  
Sylvie Félix ◽  
David Gachoud ◽  
Matteo Monti ◽  
Mirjam Schuler Barazzoni ◽  
...  

Abstract Background: Gender bias induces gender inequality in health. In this study, we evaluated gender bias during a local objective structured clinical examination (OSCE). Methods: We assessed gender bias by using two clinical cases—generalized anxiety disorder (GAD) and ascending aorta dissection (AAD)—during an OSCE performed among fifth-year medical students. For each situation, half of the students encountered male and half encountered female standardized patients (SPs). Except for gender, variables were identical in each clinical case. Patients, students, and examiners were blinded to the purpose of the study. Medical history, clinical examination, diagnosis, and management were compared between male and female SPs. The interaction between student and SP gender was analyzed. Results: A total of 110 medical students were observed (55% women). For GAD, students arrived at the correct diagnosis more often for female SPs than for male SPs (diagnosis completed, partially completed, and not completed in 47%, 16%, and 36%, respectively, of female SPs vs. 22%, 20%, and 58%, respectively, of male SPs, p = 0.02). The nature of their symptoms was more often asked of male SPs (completed, partially completed, and not completed in 51%, 4%, and 0% of male SPs, respectively, vs. 38%, 17%, and 0% of female SPs, respectively, p = 0.002), and associated physical symptoms were more often explored in female SPs (completed and not completed in 84% and 16% of female SPs, respectively, vs. 65% and 35% of male SPs, respectively, p = 0.03). For AAD, an emergency was better identified in female SPs (95% identified in female SPs vs. 76% in male SPs, p = 0.005) and examination of femoral pulses was more often performed in female SPs (88% completed in female SPs vs. 54% in male SPs, p < 0.0001). The interaction between SP and student gender was not significant. Conclusion: The gender bias observed supports the need to address unconscious biases and to raise student awareness of gender stereotypes likely to lead to underrecognition or subtreatment of disease in patients of both genders.


2019 ◽  
Vol 34 (2) ◽  
pp. 125-131
Author(s):  
Kevin K. Fong ◽  
Susannah Gilder ◽  
Rebecca Jenkins ◽  
Petra L. Graham ◽  
Benjamin T. Brown

Objective To investigate the influence of providing online procedural videos to postgraduate chiropractic students preparing for an objective structured clinical examination (OSCE). Methods Eighty-three postgraduate chiropractic students enrolled in a diagnostic unit during 2017 received supplemental video resources prior to their final OSCE. Ninety students enrolled in the 2016 offering of the unit acted as the control group. Two-sample t tests were used to compare OSCE results between groups and paired t tests were used for within-group comparisons. Regression analysis was used to examine the association of age, undergraduate grade point average, and gender with the final OSCE scores. Students were also surveyed regarding their perceptions of the video resources using a purpose-built questionnaire. Results A paired t test comparing initial and final OSCE scores found a small but significant increase in scores for the 2017 (mean change 3.6 points; p = .001) but not the 2016 (mean change −1.1 scores; p = .09) cohort. The 2017 cohort had significantly more change than the 2016 cohort (mean difference 4.7 points; p &lt; .001). Analysis of responses to the questionnaire highlighted overall positive feedback for the procedural videos. Conclusion Online procedural videos as learning resources had a small but positive effect on OSCE performance for a group of postgraduate chiropractic students. Students perceived the resource as being helpful for OSCE preparation.


Pflege ◽  
2016 ◽  
Vol 29 (4) ◽  
pp. 193-203 ◽  
Author(s):  
Angelika Beyer ◽  
Adina Dreier ◽  
Stefanie Kirschner ◽  
Wolfgang Hoffmann

Zusammenfassung. Hintergrund: Aufgrund der demografischen und epidemiologischen Entwicklung wird die Vermittlung adäquater pflegerischer Kompetenzen in der pflegerischen Ausbildung zunehmend diskutiert. Kompetenzen sind in den Examina angemessen zu überprüfen. Hierfür haben sich international OSCEs bewährt. Ziel: Ziel der vorliegenden Analyse war die Ermittlung von Kompetenzen, die in pflegerischen Erstausbildungen mit OSCEs überprüft werden. Methodik: In internationalen Datenbanken wurden einschlägige Publikationen recherchiert. Analyse-Einschlusskriterium war die Nennung mindestens einer überprüften Kompetenz. Die Kompetenzen wurden – in Anlehnung an den «Fachqualifikationsrahmen Pflege für die hochschulische Bildung» – nach Wissen, Fertigkeiten und Haltung kategorisiert. Ergebnisse: 36 Artikel erfüllten das Einschlusskriterium. Relevante Studien stammen mehrheitlich aus Großbritannien (UK), Kanada und Australien. Es wurden insgesamt n = 166 Kompetenzen in allen Kategorien identifiziert, die anhand verschiedener Methoden gemessen wurden. Am häufigsten wurden Fertigkeiten überprüft. Dabei wurde der sichere Umgang mit Medikamenten am häufigsten thematisiert. Weitere wichtige Themen waren die Kommunikationskompetenz in Bezug auf PatientInnen und die Fähigkeit zur Selbsteinschätzung. Diskussion: Es werden sehr unterschiedliche Kompetenzen mit differenten Formaten per OSCE gemessen. OSCE ermöglichen eine Überprüfung sowohl auf individueller als auch institutioneller Ebene, also sowohl für die Lehre als auch das Gelernte. Weiterer Forschungsbedarf wird festgestellt.


2018 ◽  
Vol 16 (1) ◽  
pp. 53
Author(s):  
Bejo Danang Saputra

Perencanaan pengembangan uji kompetensi perawat Indonesia akan dikembangkan  dengan metode OSCE.. Pelaksanaan uji OSCE membutuhkan persiapan yang matang, terutama kesiapan sumber daya manusia (SDM) dalam hal ini adalah dosen untuk melaksanakan uji OSCE. Mengetahui kesiapan SDM dalam pengembangan uji OSCE di Prodi D3 Keperawatan Sekolah Tinggi Ilmu Kesehatan (STIKES) Al-Irsyad Al-Islamiyyah Cilacap. Desain penelitian yang digunakan adalah kualitatif dengan rancangan studi kasus. Informan penelitian adalah 6 orang dosen dan Kepala Program Studi D3 keperawatan. Data diperoleh melalui, focus group discussion, wawancara mendalam dan studi dokumentasi. Data kemudian dianalisis dengan menggunakan constant comparative method. Penelitian menunjukan bahwa pengetahuan dosen tentang OSCE dan kompetensi berdasarkan pendidikan memenuhi persyaratan untuk pengembangan uji OSCE, namun masih membutuhkan pelatihan mengenai OSCE. Uji OSCE dapat diselenggarakan dengan melibatkan dosen dari prodi lain karena jumlah dosen di Prodi D3 Keperawatan  STIKES Al-Irsyad Al-Islamiyyah Cilacap belum memenuhi kebutuhan pelaksanaan uji OSCE. Hambatan penyelenggaraan OSCE adalah SDM belum terkoordinasi, belum terlatih dan keterbatasan sarana pendukun. Pengetahuan dan kompetensi dosen berdasarkan tingkat pendidikan memenuhi syarat dalam pengembangan OSCE dan OSCE dapat diselenggarakan dengan melibatkan dosen prodi lain.


Author(s):  
Andy Bell ◽  
Jennifer Kelly ◽  
Peter Lewis

Abstract:Purpose:Over the past two decades, the discipline of Paramedicine has seen expediential growth as it moved from a work-based training model to that of an autonomous profession grounded in academia.  With limited evidence-based literature examining assessment in paramedicine, this paper aims to describe student and academic views on the preference for OSCE as an assessment modality, the sufficiency of pre-OSCE instruction, and whether or not OSCE performance is a perceived indicator of clinical performance.Design/Methods:A voluntary, anonymous survey was conducted to examine the perception of the reliability and validity of the Objective Structured Clinical Examination (OSCE) as an assessment tool by students sitting the examination and the academics that facilitate the assessment. Findings:The results of this study revealed that the more confident the students are in the reliability and validity of the assessment, the more likely they are to perceive the assessment as an effective measure of their clinical performance.  The perception of reliability and validity differs when acted upon by additional variables, with the level of anxiety associated with the assessment and the adequacy of feedback of performance cited as major influencers. Research Implications:The findings from this study indicate the need for further paramedicine discipline specific research into assessment methodologies to determine best practice models for high quality assessment.Practical Implications:The development of evidence based best practice guidelines for the assessment of student paramedics should be of the upmost importance to a young, developing profession such as paramedicine.Originality/Value: There is very little research in the discipline specific area of assessment for paramedicine and discipline specific education research is essential for professional growth.Limitations:The principal researcher was a faculty member of one of the institutions surveyed.  However, all data was non identifiable at time of data collection.  Key WordsParamedic; paramedicine; objective structured clinical examinations; OSCE; education; assessment.


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